The NIH Pediatric Allergy Clinic continues to provide residents in the NIAID Allergy and Immunology Clinical Fellowship Program with medical training and continuity clinic experience in pediatric allergic diseases including asthma, allergic rhinitis, food allergy, atopic dermatitis and urticaria. During the past fiscal year, patient care visits have more than doubled, exceeding 500, with a total accrual of 180 new patients. The establishment this year of the allergen immunotherapy clinic has clearly contributed to this growth. [unreadable] [unreadable] In addition to standard diagnostic testing for allergic diseases which includes skin prick testing, RAST testing, patch testing and pulmonary function testing, the clinic has integrated other modalities in the evaluation of children with allergic diseases. Acoustic rhinometry, a non-invasive sound-based tool that measures nasal volume is currently used to objectively assess nasal obstruction and response to therapy. A review of this technology in the practice of allergy has been published this year in Annals of Allergy, Asthma and Immunology. [unreadable] [unreadable] In the evaluation of lung function, impulse oscillometry, a non-invasive, non-effort dependant technique that measures lung resistance and elasticity, is being used in conjunction with standard pulmonary function testing in older children and by itself in infants as young as two years old. [unreadable] In conjunction with other investigators in the LAD, expired breath condensate pH and exhaled nitric oxide measurements may be obtained for diagnostic and research purposes. Through consultation with the NHLBI pulmonology service, exercise challenge pulmonary function testing has been performed. [unreadable] [unreadable] Research blood is collected for screening laboratory studies, to measure markers of allergic diseases, to develope approaches to culture mast cells from blood, and to determine cytokine, signaling and eosinophil profiles. Data and results from these studies are being saved and analyzed. [unreadable] [unreadable] Patient documentation for communication with referring physicians and for longitudinal analysis is entered into CRIMSON, the NIAID database system.